Orthopaedic and Post Operative Studies

Hip Replacement - Frances

Objective

To rehabilitate and improve mobility following hip replacement surgery.

Background

At the age of 84 it was important to Frances to recover a level of mobility and independence following a full hip replacement.

Programme

  • Duration: 25 minutes
  • Water Temperature: 37˚C
  • Speed: 0.2 to 1.0kph as sessions developed
  • Depth: 1150mm
  • Resistance Jets: Activated to relax calves
  • Direction: Forwards
  • Number of Sessions: 4

Advantages and Outcomes

The outward opening door ensured getting in and out of the treadmill posed no problems. Ability to set the water to a precise depth allowed a comfortable level of buoyancy for Frances, permitting independent movement for the first time since her operation. The depth can be adjusted to suit individual height and weight, maintaining the optimum level of support and resistance.

The treadmill's low starting speed assisted Frances' first steps to rehab. A comfortable temperature helped with pain reduction, which increased range of motion and stride length. Psychological benefits included a belief that recuperation was possible, boosting overall confidence.

Spinal Surgery - Wendy

Objective

Rehabilitation following spinal surgery.

Background

Following spinal surgery Wendy struggled to mobilise for more than two to three minutes before having to sit down to relieve her symptoms. Her walking speed was extremely slow, her posture was stooped and she was in constant pain.

Programme

  • Duration: 30 minutes per session
  • Water Temperature: 31˚C
  • Speed: 2.0 to 4.0kph as sessions developed
  • Depth: 1100mm
  • Resistance Jets: Not activated
  • Direction: Forwards and reverse
  • Number of Sessions: 12

Advantages and Outcomes

Wendy's treatment plan included sessions in the HYDRO PHYSIO treadmill and in the WELLBEING pool. The water decompressed her spine and allowed a greater range of movement while exercising.

The sessions were designed to work all muscle groups and provide the opportunity to increase exercise intensity without the risk of injury. Poor posture and mobility meant that knee and hip pain had also become a problem for Wendy but this reduced during her treatment.

As a result, not only has Wendy's muscle strength, tone and flexibility improved, she's lost weight and is feeling much more positive about her situation.

Pre and Post Knee Surgery - Kulvinder

Objective

Intensive pre and post knee surgery rehabilitation.

Background

Thirty year old professional wrestler Kulvinder sustained a serious knee injury during a match. The knee dislocated causing multiligament damage and a lateral plateau fracture

Programme

  • Duration: 30 minutes per session
  • Water Temperature: 31˚C
  • Speed: 1.0 to 7.0kph as sessions developed
  • Depth: 1000mm
  • Resistance Jets: Not activated
  • Direction: Forward and reverse
  • Number of Sessions: 20 pre-op and 20 post-op

Advantages and Outcomes

Re-constructive knee surgery was postponed for two months to allow the ligaments to begin repairing. An intensive 10-day programme began to prepare for surgery. Strengthening supporting muscles, improving flexibility and reducing the swelling aiding post-op recovery. Kulvinder walked in the Underwater Treadmill and performed knee exercises in the Wellbeing Pool twice daily.

Pre-op the consultant commented on the "exceptional physiotherapy" he had undergone and confirmed that the posterior crutiate ligament (PCL) and lateral collateral ligament (LCL) were fully repaired. The medial collateral ligament (MCL) had repaired itself but was slightly loose and required surgery, along with a new donor anterior cruciate ligament (ACL).After surgery, Kulvinder continued an intensive 10-day rehabilitation programme. He progressed to walking without crutches and reducing his limp, fast-tracking his road to recovery.

Shoulder Surgery - Christoper

Objective

Rehabilitation following shoulder surgery (Weaver-Dunn Procedure).

Background

A horse riding accident left Christopher with a dislocated acromioclavicular joint, which required reconstructive shoulder surgery. Recovery time was estimated at 12 and 16 weeks, but the need to return to work sooner led him to a more proactive approach towards his rehabilitation.

Programme

  • Duration: 30 minutes per session
  • Water Temperature: 32˚C
  • Speed: 2.5kph gradually increasing to 7.0kph
  • Depth: 1100mm
  • Resistance Jets: Not activated
  • Direction: Forwards and backwards
  • Number of Sessions: 8

Advantages and Outcomes

Ten days post op Christopher began Aquatic therapy in the HYDRO Treadmill. Christopher started walking at a slow pace with the water-level high, which increased the buoyancy. The walking motion gently exercised his shoulder and allowed only moderate movement.

Part of Christopher's treatment included sessions in the wellness pool as exercises in the 38ºC water assisted with the internal and external rotation of the shoulder and active range of movement.

After three sessions, Christopher could remove his sling and after his seventh session he reported that he felt 80% better. He was fully recovered after just eight sessions.

Hip Replacement - Sue

Objective

Rehabilitation following a hip replacement operation.

Background

10 weeks after Sue’s operation she completed the limited physiotherapy and hydrotherapy that was available to her post-op. She suffers with lower back pain as a result of her previous mobility problems. Not feeling as mobile as she hoped started at an Aquatic Therapy programme to continue her rehabilitation.

Programme

  • Duration: 30 minutes
  • Water Temperature: 31˚C
  • Speed: 3.0kph
  • Depth: 1100mm
  • Resistance Jets: Not activated
  • Direction: Forwards and backwards
  • Number of Sessions: 10

Advantages and Outcomes

Setting the water-level above Sue's hips gave her support and buoyancy. The low starting speed assisted her steps towards rehabilitation and allowed the physiotherapist to monitor her movements precisely.

With a constant temperature of 31ºC, Sue's pain was greatly reduced, which helped to increase her range of motion and stride length and maximise the training session. The sessions also benefited Sue psychologically as it boosted her overall confidence and helped her feel well on the way to recovery.

Hip and Spinal Injuries - Russell

Objective

Rehabilitation post accident.

Background

Russell sustained serious injuries to his hip and spine following a motorbike accident.

Programme

  • Duration: 30 minutes per session
  • Water Temperature: 32˚C
  • Speed: 1.00kph gradually increased to 4.7kph
  • Depth: 1200mm down to 1000mm
  • Resistance Jets: Not activated
  • Direction: Forwards and Backwards
  • Number of Sessions: 46 (2 per week)

Advantages and Outcomes

Russell was involved in a road traffic accident on his motorbike where he sustained a fractured pelvis and crushed discs in his lower back. He needed two crutches to be able to mobilise and was in a great deal of pain due to the fracture and subsequent nerve compression.

Russell's programme comprised of sessions in the HYDRO PHYSIO treadmill and exercises in the Wellbeing Pool complimented by physiotherapy.

The objective has been to build supportive muscles, build core strength and promote faster recovery. We are pleased to be able to report that Russell is now able to walk without crutches and feels that he's well on the way to make a full recovery.

Complex Fractured Foot - Maurice

Objective

Rehabilitation following crush injury to right foot.

Background

Maurice sustained a complex fracture and dislocation of his right foot, following an accident at work in which he was hit by a forklift truck. Over the course of several months, he underwent a series of reconstructive operations and was left with poor mobility and constant pain.

Programme

  • Duration: 30 minutes
  • Water Temperature: 34˚C
  • Speed: 1.0kph to 2.8kph
  • Depth: 1200mm
  • Resistance Jets: Not activated
  • Direction: Forwards and sideways
  • Number of Sessions: 40

Advantages and Outcomes

Maurice had poor mobility, reliant on one crutch and only able to walk for 100 yards before stopping to rest. Exercising in the HYDRO treadmill, with reduced pressure on his foot, allowed him to mobilise more comfortably. This helped to strengthen the supporting muscles, which in turn encouraged greater weight bearing. Being able to put weight on the foot creates osteoblasts that knit the bones together and promote faster healing. Maurice was able to perform more dynamic exercises without pain in the Wellbeing Pool.

New Femur - Pat

Objective

Rehabilitation following pioneering surgery to replace a femur.

Background

An early hip replacement set the tone for Pat Newell, as more replacements followed and eventually the need for pioneering surgery to give her a new femur.

Programme

  • Duration: 30 minutes per session
  • Water Temperature: 31˚C
  • Speed: 2.00kph gradually increased to 4.0kph
  • Depth: 1100mm
  • Resistance Jets: Not activated
  • Direction: Forwards and backwards
  • Number of Sessions: 12

Advantages and Outcomes

Pat had very poor mobility she could only walk 10-15 metres at a slow speed, using two sticks. After 12 sessions she walks further, quicker and is a lot less reliant on her sticks. Rehabilitation on the HYDRO treadmill has improved Pat's day-to-day life as she is now able to get out and about much more. This greater independence, together with the reduction in pain, has resulted in Pat feeling happier and more fulfilled.

Weight loss and improved muscle strength have had a significant impact on Pat's recovery and will continue to contribute to a much healthier future.

Ankle Fusion Surgery - Jack

Objective

Rehabilitation following a broken ankle which resulted in ankle fusion surgery.

Background

Having fallen from a tree and broken his ankle some years ago, Jack suffered ongoing problems and eventually had ankle fusion surgery. His was poor due to pain and limited movement and he also needed to wear an air cast boot.

Programme

  • Duration: 35 minutes
  • Water Temperature: 31˚C
  • Speed: 2.0kph gradually increased to 2.5kph
  • Depth: 1200mm
  • Resistance Jets: Not activated
  • Direction: Forwards
  • Number of Sessions: 6

Advantages and Outcomes

Jack was given an individual programme of HYDRO treadmill sessions combined with cold and compression therapy to loosen up his ankle and reduce inflammation. Jack has had six sessions so far and already enjoys 40% improvement in his ankle flexion and extension. He can walk further, in a lot less pain and no longer uses the air cast boot.

A key objective in Jack's treatment was to prevent any long-term damage to his spine, knees and hips, which may arise from walking difficulties.

ACL Surgery - Harsimran

Objective

Rehabilitation following a football injury which resulted in knee surgery to repair the anterior cruciate ligament (ACL).

Background

Harsimran underwent reconstructive knee surgery three weeks before his first HYDRO PHYSIO session. Following the operation, he was on two crutches with minimal weight bearing on his leg and forced to sit around doing nothing.

Programme

  • Duration: 20 minutes
  • Water Temperature: 31˚C
  • Speed: 0.5kph gradually increased to 3.0kph
  • Depth: 1145mm
  • Resistance Jets: Not activated
  • Direction: Forwards, backwards and sideways
  • Number of Sessions: 3

Advantages and Outcomes

Walking pain-free on the treadmill enabled Harsimran to walk forwards, backwards and sideways dynamically as well as performing squats and single leg squats in the second. The water-based exercise allowed the joints to be loosened off, muscles to be cushioned and foot lift went from barely off the treadmill to at least 10cms.

The extension lag on the supporting leg went from -15º to -5º and flexion in the knee went from 30º to 90º after just two sessions.